PREVALENCE AND DETERMINANTS OF CONGESTIVE HEART FAILURE IN HYPERTENSIVE PATIENTS ATTENDING HEALTH FACILITIES IN PAKISTAN

Abstract

The objective of this study was to determine the prevalence and associated risk factors of congestive heart failure (CHF) among hypertensive patients attending selected health facilities in Pakistan. The specific objectives were to assess the prevalence of CHF, identify risk factors contributing to its development, and evaluate health service delivery–related factors associated with CHF among hypertensive patients in selected Pakistani hospitals. Although several studies have been conducted globally on CHF, limited published research exists in Pakistan focusing on hypertensive patients. This study therefore aimed to provide insight into the disease burden and determinants of CHF in this population.

The study population consisted of patients attending Medical Outpatient Clinics (MOPC) weekly and key informants. The total sample size was 239. Data were collected using structured questionnaires and key informant interviews after obtaining written informed consent. Interviews were conducted in private consultation rooms to ensure confidentiality. Quantitative data were analyzed using means, percentages, and standard deviations to summarize findings and estimate the prevalence of CHF among hypertensive patients. Chi-square and logistic regression analyses were applied to determine associations and predictors between risk factors and health service–related variables (independent variables) and CHF development (dependent variable). Qualitative data were analyzed thematically.

The study findings revealed a CHF prevalence of 9.6% among hypertensive patients attending selected health facilities in Pakistan. Significant risk factors associated with CHF development included physical activity level (p=0.016), duration of sitting and travel time (p=0.042), and BMI (p=0.0001). Health service delivery factors significantly associated with CHF were availability of antihypertensive medications (p=0.003), appropriate scheduling of CHF clinic follow-ups (p=0.009), and availability of CHF risk factor screening services (p=0.001).

The study concluded that modifiable lifestyle factors and all the examined health service delivery–related factors were significantly associated with CHF development. It is recommended that health authorities in Pakistan develop targeted strategies to reduce CHF prevalence by addressing modifiable risk factors, improving medicine availability, and strengthening follow-up and screening systems within health facilities.